Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center.

Published on May 7, 2017in World Journal of Gastroenterology3.665
· DOI :10.3748/WJG.V23.I17.3077
Salvatore Paiella23
Estimated H-index: 23
,
Matteo De Pastena12
Estimated H-index: 12
+ 15 AuthorsRoberto Salvia52
Estimated H-index: 52
Sources
Abstract
Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center
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10 Authors (Aun Jamal, ..., Aamir Ali Syed)
References24
Newest
#1Renato Costi (University of Verona)H-Index: 1
#1Renato CostiH-Index: 24
Last. Claudio BassiH-Index: 110
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Background Endoscopic stenting has spread as bridge management before pancreatoduedenectomy (PD) to resolve jaundice, but its role is nowadays challenged as it is reported to increase morbidity. Although bile sampling is increasingly performed, its clinical role is unclear. The objective of the study is to assess bile colonization’s impact on outcome.
14 CitationsSource
#1Chun-Ming Chang (TCU: Tzu Chi University)H-Index: 13
#2Wen-Yao Yin (TCU: Tzu Chi University)H-Index: 11
Last. Ching-Chih Lee (NDMC: National Defense Medical Center)H-Index: 24
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Background Identification of patients at risk of death from cancer surgery should aid in preoperative preparation. The purpose of this study is to assess and adjust the age-adjusted Charlson comorbidity index (ACCI) to identify cancer patients with increased risk of perioperative mortality. Methods We identified 156,151 patients undergoing surgery for one of the ten common cancers between 2007 and 2011 in the Taiwan National Health Insurance Research Database. Half of the patients were randomly ...
70 CitationsSource
#1David Y. Lee (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 14
#2Jamie A. Schwartz (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 6
Last. Fadi Attiyeh (Mount Sinai St. Luke's and Mount Sinai Roosevelt)H-Index: 5
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Abstract Background Most series analyzing outcomes of pancreaticoduodenectomy in octogenarians are limited by a small sample size. The investigators used the American College of Surgeons National Surgical Quality Improvement Program database for an analysis of the impact of advanced age on outcomes after pancreatic cancer surgery. Methods The National Surgical Quality Improvement Program database from 2005 to 2010 was accessed to study the outcomes of 475 pancreaticoduodenectomies performed in p...
35 CitationsSource
#1Rajesh Sehgal (Cabell Huntington Hospital)H-Index: 1
#2Mohamed AlsharediH-Index: 6
Last. Todd GressH-Index: 9
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Objectives Pancreatic cancer is a lethal disease mostly affecting elderly people. Clinical trials on treatment contain disproportionately fewer elderly patients compared with everyday practice. This retrospective study evaluates differences in the rates of chemotherapy delivered and associated survival in different age groups. Methods Data were collected from the Cancer Information Resource Files on patients diagnosed with pancreatic cancer from 1993 to 2008. Patients were divided into 3 age gro...
27 CitationsSource
#1Adnan Nagrial (Garvan Institute of Medical Research)H-Index: 27
#2David K. ChangH-Index: 48
Last. Andrew V. BiankinH-Index: 73
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Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer. We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resec...
45 CitationsSource
#1Seiji Oguro (Juntendo University)H-Index: 8
#2Kazuaki ShimadaH-Index: 67
Last. Tomoo Kosuge (Juntendo University)H-Index: 8
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Purpose Although a pancreaticoduodenectomy (PD) has been recently regarded as a safe surgical procedure at high-volume centers, the efficacy of PD for patients 80 years of age and older is controversial. The aim of this study was to evaluate the perioperative and long-term outcomes following PD in patients 80 years of age and older.
43 CitationsSource
#2Thoens JonathanH-Index: 1
Last. DeVito PeterH-Index: 1
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Background The aim of this meta-analysis was to analyse the outcomes of major pancreatic surgery among the elderly (≥75 and ≥80 years of age).
98 CitationsSource
#1Marcovalerio Melis (NYU: New York University)H-Index: 18
#2Francesca Marcon (NYU: New York University)H-Index: 9
Last. Elliot Newman (NYU: New York University)H-Index: 17
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Background A pancreaticoduodenectomy (PD) offers the only chance of a cure for pancreatic cancer and can be performed with low mortality and morbidity. However, little is known about outcomes of a PD in octogenarians.
54 CitationsSource
#1A.W.C. Kow (TTSH: Tan Tock Seng Hospital)H-Index: 2
#2N.A. Sadayan (NUS: National University of Singapore)H-Index: 1
Last. Kui Hin Liau (TTSH: Tan Tock Seng Hospital)H-Index: 9
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Abstract Background Although mortality & morbidity for pancreaticoduodenectomy (PD) have improved significantly over the last two decades, the concern for elderly undergoing PD remains. This study examines the outcome of the elderly patients who had pancreaticoduodenectomy in our institution. Methods A prospective database comprising 69 patients who underwent pancreaticoduodenectomy between 2001 and May 2008 was analyzed. Using WHO definition, elderly patient is defined as age 65 and above in th...
30 CitationsSource
#2Kyla M. Bennett (Duke University)H-Index: 18
Last. John E. Scarborough (Duke University)H-Index: 26
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Background Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database.
38 CitationsSource
Cited By7
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#1Jaime de la FuenteH-Index: 2
#2Shounak MajumderH-Index: 13
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#1Gregorio Di Franco (UniPi: University of Pisa)H-Index: 13
#2Matteo Palmeri (UniPi: University of Pisa)H-Index: 12
Last. Luca Morelli (UniPi: University of Pisa)H-Index: 21
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Background More than 60% of patients affected by pancreatic cancer are ≥ 65 years of age. Surgery represents the only potentially curative treatment for malignant pancreatic neoplasia and a useful treatment for benign diseases.
4 CitationsSource
Background: Although mortality and morbidity of pancreatoduodenectomy (PD) have improved significantly over the past years, the impact of age for patients undergoing PD is still debated. This study is aimed at analyzing short- and long-term outcomes of PD in elderly patients. Methods: 124 consecutive patients who have undergone PD for pancreas neoplasms in our center between 2012 and 2017 were analyzed. Patients were divided into two groups: group I ( /=75 years). Demographic features and intrao...
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#1Masayuki Akita (Kobe University)H-Index: 10
#2Tetsuo Ajiki (Kobe University)H-Index: 26
Last. Takumi Fukumoto (Kobe University)H-Index: 25
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Abstract Background Pancreaticoduodenectomy (PD) is a standardized strategy for patients with middle and distal bile duct cancers. The aim of this study was to compare clinicopathological features of bile duct segmental resection (BDR) with PD in patients with extrahepatic cholangiocarcinoma. Methods Consecutive cases with extrahepatic cholangiocarcinoma who underwent BDR (n=21) or PD (n=84) with achievement of R0 or R1 resection in Kobe University Hospital between January 2000 and December 2016...
1 CitationsSource
#1Lucila M. Perrotta de Souza (UFRJ: Federal University of Rio de Janeiro)H-Index: 1
#2Jessica Pl Moreira (UFRJ: Federal University of Rio de Janeiro)H-Index: 1
Last. Heitor S. de Souza (UFRJ: Federal University of Rio de Janeiro)H-Index: 6
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Abstract Background Currently, surgical resection represents the only curative treatment for pancreatic cancer (PC), however, the majority of tumors are no longer resectable by the time of diagnosis. The aim of this study was to describe time trends and distribution of pancreaticoduodenectomies (PDs) performed for treating PC in Brazil in recent years. Methods Data were retrospectively obtained from Brazilian Health Public System (namely DATASUS) regarding hospitalizations for PC and PD in Brazi...
1 CitationsSource
#1Fang Yuan (UVA: University of Virginia)H-Index: 1
#2Yasmin Essaji (McMaster University)H-Index: 1
Last. Pablo E. Serrano (McMaster University)H-Index: 11
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Abstract Background Complications frequently occur after pancreaticoduodenectomy. Patients undergoing pancreaticoduodenectomy tend to be older; age and postoperative complication may be associated. To clarify this association, we compared postoperative outcomes in patients undergoing pancreaticoduodenectomy based on age group. We aimed to determine whether we could identify an age cutoff where the incidence and cost of postoperative complications starts increasing and potentially outweigh the po...
9 CitationsSource
#1Zachary E. Stiles (UTHSC: University of Tennessee Health Science Center)H-Index: 7
#2Stephen W. Behrman (UTHSC: University of Tennessee Health Science Center)H-Index: 29
Last. Paxton V. Dickson (UTHSC: University of Tennessee Health Science Center)H-Index: 13
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BACKGROUND AND OBJECTIVES: Outcomes and recommendations regarding adjuvant therapy (AT) for stage I ampullary adenocarcinoma (AAC) are inadequately described. We sought to determine factors associated with survival and better define the impact of AT. METHODS: The NCDB was queried for stage I AAC patients undergoing resection. We evaluated variables influencing the administration of AT and affecting survival, including the receipt of AT. RESULTS: Five hundred thirty-seven patients were identified...
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